Leticia Mora Fausto

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

410 Jones St Ste C1
Ukiah, CA 95482-5491

Phone

(707) 463-0405

NPI assigned

Jun 25, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Manzanita Services Inc.

  • Community/Behavioral Health Agency
  • Ukiah, CA
  • NPI 1831523091
  NPD (past)
• Tapestry Family Services, Inc.

  • Community/Behavioral Health Agency
  • Ukiah, CA
  • NPI 1568191757
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1529884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583884800000",
    "number": "1861987679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 S DORA ST",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954826340",
            "telephone_number": "707-472-2637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 JONES ST STE C1",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954825491",
            "telephone_number": "707-463-0405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAUSTO",
        "first_name": "LETICIA",
        "middle_name": "MORA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-25",
        "last_updated": "2020-03-11",
        "certification_date": "2020-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Larry Charles Falk, M.D.
• Patty Fallahee
• Donna L. Farmer, F.N.P.
• Gary Fausone, MD
• Christalina Fausto
• Alexandra S. Feeny
• Thomas Feiertag, P.A.
• Marisa Feliciano-Garcia
• Fabiola Fernandez
• Sam Fernandez, LCSW

• Addiction (Substance Use Disorder) Counselor in Ukiah, CA
• Providers in Ukiah, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.